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At present, the use of medicines, especially antibiotics, has increased significantly, and this affects domestic waste. The human population contributes to the spread of antibiotic residue into the environment either via excretion of pharmaceuticals during the ordinary course of treatment or by improperly disposing of unused medication in toilets. This study aims to study the effect of pharmaceutical residues, particularly antibiotics, on the removal efficiency of ammonium and COD in domestic wastewater, using anaerobic batch reactor. The reactor inoculated with a septic tank and an artificial waste. The stages of this research were seeding, acclimatization, and running. This research was conducted for 30 days with the reactor volume at 8.5 liters of seeding and acclimatization time and 1.5 liters of running time. Efficiency removal of COD were 89.66%; 88.24%; 85.21%; 78.27% and 77.72%. Meanwhile, the efficiency removal of ammonium are 55.08%; 53.30%; 48.13%; 40.36% and 32.16%. The reactor with the highest pharmaceutical residue did not contribute to the efficiency of COD removal but affected the effectiveness of ammonium removal.